Eczema, also known as atopic eczema or atopic dermatitis, is an inflammatory, allergic skin disease commonly and frequently encountered in dermatology. Clinically, eczema is mainly manifested as recurrent itchiness and symmetrically distributed pleomorphic lesions and characterized in symmetrically distributed pleomorphic skin lesions, severe itchiness, a tendency to oozing, recurrence, refractoriness, proneness to chronicity and persistence, etc. Histological characteristics include edema between epidermal cells, accompanied by varying degrees of acanthosis and lymphohistiocytic infiltration around superficial vessels.
At present, the pathogenesis of eczema has not yet been fully elucidated in Western medicine. Well-accepted possible causes mainly include allergies, skin barrier defects, pathogenic microbial colonization, inflammatory mediator release, genetic polymorphisms or mutations and other environmental factors. Eczema can be specified as acute, sub-acute or chronic, depending upon the appearance of lesions and may induce Staphylococcus aureus skin infections, herpes simplex virus infections, warts, infectious plaques or other conditions.
Eczema can endanger the lives and health of patients. Patients with acute or chronic eczema often suffer from erosions caused by scratching, which are prone to secondary infections that may lead to pustules and local swollen lymph nodes. Chronic eczema can lead to thickened, moss-like, local skin lesions with a protracted course. Some patients may develop life-threatening systemic diseases such as serious liver and kidney damage due to excessive medication throughout the protracted course of treatment.
The impact of eczema on patients is not limited to the physical pain and suffering, but more lies in degrading their quality of life (QOL). Rash and severe itching may inhibit the patient's normal life and work and lead to lack of sleep. Generally, a patient with eczema has a probability of 60% of sleep disorders and even higher during onset of the disease. Another reason for QOL degradation due to eczema is dietary restrictions. Other consequences of eczema include listlessness, irritability and other mental disorders resulting from prolonged treatment, impaired appearance due to papules, papules, blisters, oozing, erosions, scalp scabs, pigmentation of eczema lesions, and psychological pressures and poor mental health because of some characteristics of the disease such as unidentifiable causes and allergens, proneness to recurrence and a protracted course.
In Western medicine, eczema is typically treated following the principles of controlling skin inflammation, relieving itching, delaying and mitigating progression, recovering or strengthening the skin barrier function and improving and enhancing patient QOL based on patients' individual needs while comprehensively considering their age, severity, lesion site, infection, past treatment and other conditions.
In general, the treatment is medical or surgical and involves the use of H1 receptor antagonists (antihistamines), non-specific anti-allergic drugs, corticosteroids, immunomodulators or antibiotics. Most of these drugs, however, cannot fundamentally eradicate the disease but can only temporarily suppress its onset and relieve its symptoms at the cost of many side effects, for example, lethargy, drowsiness, dry mouth, vomiting, diarrhea, constipation, urinary retention and so on arising from the use of antihistamines. Use of corticosteroids can cause obesity, hirsutism, acnes, hyperglycemia, hypertension, hypernatremia, edema, hypokalemia, menstrual disorders, osteoporosis, aseptic bone necrosis, gastric and duodenal ulcers and other complications, addiction and exacerbation after withdrawal. Clinically, there are many patients who fear the use of hormones. In such cases, the treatment will be affected due to a limited choice of mediations and poor patient compliance.